EAST TEXAS BORDER HEALTH CLINIC (GENESIS PRIMECARE) - NPI NUMBER 1700134996
Provider Name: EAST TEXAS BORDER HEALTH CLINIC (GENESIS PRIMECARE)
NPI Number: 1700134996
Clasification: General Practice (208D00000X)
502 E RUSK ST
Phone Number: (903) 927-3782
EAST TEXAS BORDER HEALTH CLINIC is a general practitioner in Marshall, TX. The assigned NPI number for this provider is 1700134996 and is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Genesis Primecare.
The provider's business address is:
502 E RUSK ST
Phone: (903) 927-3782
Fax: (903) 927-1764
The provider's authorized official is David L Hartman .
The authorized official title is Ceo and has the following contact phone number (903) 927-3782.
The enumeration date for this NPI number is 8/21/2012 and was last updated on 8/21/2012.
Map - Location of Practice
The following information regarding the scope of practice of this provider is available:
||Entity Type Code
||Employer Identification Number EIN
||Provider Organization Name Legal Business Name
||EAST TEXAS BORDER HEALTH CLINIC
||Provider Other Organization Name
||Provider Other Organization Name Type Code
||Provider First Line Business Practice Location Address
||502 E RUSK ST
||Provider Business Practice Location Address City Name
||Provider Business Practice Location Address State Name
||Provider Business Practice Location Address Postal Code
||Provider Business Practice Location Address Country Code If outside U S
||Provider Business Practice Location Address Telephone Number
||Provider Business Practice Location Address Fax Number
||Provider Enumeration Date
||Last Update Date
||Authorized Official Last Name
||Authorized Official First Name
||Authorized Official Middle Name
||Authorized Official Title or Position
||Authorized Official Telephone Number
||Healthcare Provider Taxonomy Code 1
||Healthcare Provider Primary Taxonomy Switch 1
||Is Organization Subpart
||Authorized Official Name Suffix Text
||Healthcare Provider Taxonomy Group 1
||193200000X MULTI-SPECIALTY GROUP
Download this NPI record in Text format: Export
Download this NPI record in Excel (CSV) format: Export
Download this NPI record in XML format: Export
This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.